POS1572 AN OVERVIEW TO THE INTERSTITIAL LUNG DISEASES RELATED TO CONNECTIVE TISSUE DISEASES: A RETROSPECTIVE ANALYSIS
Authors: S. Colak, E. Tekgoz, E. Cimen Gunes, N. Ocal, D. Dogan, C. Tasci, M. Çinar, S. Yilmaz
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Interstitial lung disease (ILD) is a critical manifestation of connective tissue diseases (CTDs) that may cause morbidity and mortality. <h3>Objectives</h3> This study aimed to evaluate the clinical and demographic characteristics and treatment of the patients who had CTD-related ILD. <h3>Methods</h3> This retrospective observational study includes patients who followed up with CTD-related ILD in a tertiary rheumatology outpatient clinic between January 2020 and December 2022. Patients' files were assessed retrospectively for demographic, clinical, and radiologic data. <h3>Results</h3> There were 149 patients (96 Female/53 Male) with a mean age of 62.6±11.8. The CTD types of the patients were Sjogren's syndrome (SS) in 49 (32.7%) patients, rheumatoid arthritis (RA) in 47 (31.3%) patients, systemic sclerosis (SSc) in 40 (26.7%) patients, undifferentiated CTD in 9 (6%) patients, inflammatory myositis in 3 (2%) patients, and systemic lupus erythematosus (SLE) in one (0.7%) patient. The median disease duration was 58 (24-134.5) months for CTDs. According to computed tomography findings, 86 (57.7%) patients had nonspecific interstitial pneumonia (NSIP), 48 (32.2%) patients had usual interstitial pneumonia (UIP), 9 (6%) patients had lymphocytic interstitial pneumonia (LIP), 6 (4%) patients had organizing pneumonia (OP). The median disease duration was 35.5 (12-65.8) months for ILD. Patients with NSIP were more frequent in the SSc and SS groups, with 29 (33.7%) patients for each. Both UIP and OP were most frequent in the RA group (45.8% and 66.6%, respectively). LIP was common in the SS group (77.8%). Seventy-five (50%) patients were diagnosed with CTD prior to ILD, 20 (13.3%) patients were diagnosed with ILD prior to CTD, and 54 (36%) patients had CTD and ILD diagnoses concurrently. NSIP was more frequent among female patients (p=0.001), but no significant difference was found in terms of gender among patients with UIP. Immunosuppressive (IS) treatment for ILD was more frequently initiated for patients with NSIP than for UIP. The mainly preferred drug for initiation ILD therapy was rituximab for RA patients, mycophenolate mofetil for myositis, and azathioprine for other disease groups. In addition to IS treatment, usually, 7.5-30 mg/day prednisolone was administered for both NSIP and UIP. Prednisolone up to 100mg/day was used for OP treatment. Only two patients with OP used azathioprine as IS treatment added to prednisolone. RA patients with LIP did not receive an IS treatment for pulmonary involvement. Besides, mycophenolate mofetil and azathioprine were given to two patients with LIP associated with SS. Six patients (4 NSIP/2UIP) died that of whom were using IS agents. <h3>Conclusion</h3> ILD is a critical manifestation of CTDs. IS biologic treatment options may be required during the management of CTD-related ILD. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.